Nurse Delegation Program


IMPORTANT ANNOUNCEMENT UPDATE: As of 05/30/2024, HealthCare Authority Provider Enrollment is continuing to experience up to a 6 MONTH delay processing Core Provider Agreements, a final part of the application process. This delays contractors’ ability to access the Social Service Medical Profile and bill. You SHOULD NOT start working with Medicaid clients OR accept new referrals UNTIL you are able to log into ProviderOne, view your authorizations list & have a Social Service Medical profile. We do understand the severity of this delay and want to be transparent with applicants. Please understand that if you contract with DSHS as a Nurse Delegator, you may be subject to these delays.


The DSHS Nurse Delegation Program supports DSHS Community-Based Residential Care settings. The Orientation training is for Registered Nurses interested in becoming a DSHS contracted Registered Nurse Delegator. This web page has resources for current and future RNDs in all DSHS community based residential care settings.

How to Become a Registered Nurse Delegator (RND)

Orientation classes are full for 2024. We currently do not have a waitlist. We will post the dates for 2025 in November.

Frequently Asked Questions  

What Is Nurse Delegation?

The DSHS Nurse Delegation Program, under Washington State law, allows credentialed Nursing Assistants and Home Care Aides working in DSHS Community-Based Residential Care settings to perform certain tasks--such as administration of prescription medications or blood glucose testing--normally performed only by licensed nurses. A Registered Nurse must teach and supervise the Nursing Assistant or Home Care Aide, as well as provide nursing assessments of the patient's condition.

How Can I Contract With DSHS To Provide Nurse Delegation?

Registered nurses who wish to contract with DSHS, are required to attend a free, all-day training session provided by the DSHS nurse delegation program. The RN must also complete a contract packet which you will receive after attending the class and provide the necessary documents. Contract requirements include WA state business license, liability insurance, background check, and Medicaid required documents.

What Is Required For A Registered Nurse To Do Nurse Delegation?

Any Registered Nurse in Washington State may delegate, but they may only do so according to the laws (RCW 18.79.260) and regulations (WAC 246-840-910 to 970) upheld by the Washington State Board of Nursing.

How Do I Find Clients?

DSHS provides a current public and DSHS internal list of Contracted Registered Nurse Delegators. DSHS does not automatically provide clients to the delegator; the delegator must market their services for themself. DSHS does distribute the current list of Contracted Nurse Delegators to DSHS Case Managers who authorize Nurse Delegation services for Medicaid clients qualified for services.

How does the Nurse Delegator get paid for services?

The DSHS Contracted Nurse Delegator receives authorization for services for state Medicaid clients from Case Managers in ALTSA and DDA. The contractor will then bill through Health Care Authority and ProviderOne for payment of services. 

How Do I Get Nurse Delegation Forms?

You can download all mandatory forms at the Nurse Delegation Forms page.

How Do I Find Classes?

Resources for Current RNDs with DSHS Contracts

Nurse Delegation Program Contacts